| NPI | 1164980025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN251422) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN251422) |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2023-04-06 |